Provider Demographics
NPI:1427144542
Name:MENDOZA, FERNANDO G (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:G
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 VITTORIO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2737
Mailing Address - Country:US
Mailing Address - Phone:305-562-7401
Mailing Address - Fax:
Practice Address - Street 1:BAPTIST HOSPITAL PEDIATRIC EMERGENCY DEPT.
Practice Address - Street 2:8900 NORTH KENDALL DRIVE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:786-596-3677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93023207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine